Department of Radiology, Branch Hospital in Fengxian of Shanghai No. 6 People's Hospital, Shanghai 201400, China.
Arch Gerontol Geriatr. 2013 Jan-Feb;56(1):61-7. doi: 10.1016/j.archger.2012.05.009. Epub 2012 Jun 16.
To evaluate the clinical value of low-dose cerebral CTPI in the diagnosis of senile dementia, as an attempt to develop a new imaging method to diagnose this disease and measure its severity. 95 patients of senile dementia (52 with Alzheimer's disease (AD), 43 with vascular dementia (VD)) and 30 healthy subjects (control group) were underwent low-dose cerebral CTPI examinations with multi-slices spiral CT. The CTPI images were analyzed using perfusion software. Derived perfusion parameters including cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time (MTT) and time to peak (TTP) were measured. Diagnostic value of perfusion parameters was evaluated by receiver-operating characteristic (ROC) curve. The CBV and CBF of both of frontal lobe, temporal lobe, hippocampus and basal ganglial area in the patients with senile dementia were much lower than those in the healthy group. And MTT and TTP of the areas above-mentioned in the senile dementia group were higher than those in the control group. There was statistically significant difference between them (p<0.05). The areas under ROC curves of perfusion parameters left temporal lobe MTT, left the basal ganglia MTT and left the hippocampus MTT to diagnose senile dementia were 0.959, 0.920, 0.916, and diagnostic accuracy rate is higher. The areas under ROC curve of the left frontal MTT, the left basal ganglia CBV were 0.867 and 0.819, diagnosis accuracy medium. The results showed that cerebral CTPI is valuable for the diagnosis of senile dementia.
为了评估低剂量脑 CTPI 在诊断老年性痴呆中的临床价值,尝试开发一种新的成像方法来诊断这种疾病并测量其严重程度。95 例老年性痴呆患者(52 例阿尔茨海默病(AD),43 例血管性痴呆(VD))和 30 例健康受试者(对照组)均接受多排螺旋 CT 低剂量脑 CTPI 检查。使用灌注软件分析 CTPI 图像。测量得到的灌注参数包括脑血容量(CBV)、脑血流量(CBF)、平均通过时间(MTT)和达峰时间(TTP)。通过受试者工作特征(ROC)曲线评估灌注参数的诊断价值。老年性痴呆患者的额叶、颞叶、海马和基底节区的 CBV 和 CBF 均明显低于健康组,而上述区域的 MTT 和 TTP 则高于对照组。两组间差异有统计学意义(p<0.05)。MTT 左颞叶、左基底节区 MTT 和左海马区 MTT 等灌注参数的 ROC 曲线下面积诊断老年性痴呆的面积分别为 0.959、0.920、0.916,诊断准确率较高。左额叶 MTT、左基底节区 CBV 的 ROC 曲线下面积分别为 0.867 和 0.819,诊断准确率中等。结果表明,脑 CTPI 对老年性痴呆的诊断具有一定价值。